講演情報
[I-AEPCJS-2]Surgical intervention for Infective endocarditis; when to proceed, and pitfall of procedure
○Takeshi Shinkawa (Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, JAPAN)
キーワード：
Congenital heart disease、Infective endocarditis、Surgery
The congenital heart disease (CHD) patients carry higher risk of infective endocarditis (IE) both in children and adults compared to the normal population, due to multiple prosthetic materials in the blood circulation for the CHD repair, abnormal blood stream by CHD or the residual lesions, and possible multiple surgical/catheter-based interventions. In general, surgical intervention for IE should be considered with uncontrollable heart failure due to severe valve dysfunction or prosthetic valve infection, infectious invasion beyond the valve leaflet, systemic (and pulmonary) embolization, large mobile vegetation potential to severe embolization, and uncontrollable infection despite appropriate antibiotics therapy. The surgical indication for CHD patients with IE should be same as the "regular" IE.The purpose of the surgical intervention for IE includes removal of infectious source (vegetation and infected tissues) and restoration of hemodynamic stability. The vegetations should be removed completely (or at least as much as possible) as well as infected tissues (valve leaflets, abscess, etc.). The achievement of good hemodynamics is often very difficult or impossible without prosthetic material, despite prosthetic material should ideally be avoided. We introduce our resent surgical experience to the IE in the CHD patients at our institution, and discuss the cases requiring emergent/urgent surgeries.